The changing division of labour between nurses and nursing assistants in New Brunswick.

Abstract

In 1989, the professional nursing organization that represents nurses in New Brunswick adopted baccalaureate entry to practice in nursing. This decision coincided with a major restructuring of provincial health care. Consequently, there has been a reorganization of health care worker roles which affects nurses and nursing assistants. This paper explores the changing division of labour between nurses and nursing assistants in the province of New Brunswick, Canada. The study used archival material, from the period 1978-1990, of three nursing organizations that played a significant role in initiating baccalaureate entry to practice. Interviews with 19 key people involved in the decision to upgrade nurse education were conducted. Data from the archival material and interviews were analysed jointly. There are ongoing tensions between nurses and nursing assistants. Although nurses would like a support worker, they remain ambiguous about the role of nursing assistants in health care and which tasks should be delegated to this group. Nursing leaders are concerned about the ease with which some patient-related tasks are moved to nursing assistants. In the past, these concerns have led nursing leaders to attempt to limit nursing assistant responsibilities through both legislative means and ways of organizing nursing labour (primary nursing). As a result of health care reforms and baccalaureate entry to practice for nurses, nursing assistant responsibilities are currently expanding. Upgrading nurse education, which came into effect in 1996 with the closure of diploma schools in New Brunswick, is likely to entrench the role of nursing assistants in health care because of the economic value of their work during a period of restructuring and rationalization of health care.